Kurtz Theodore W, DiCarlo Stephen E, Pravenec Michal, Morris R Curtis
University of California, San Francisco, School of Medicine, Department of Laboratory Medicine, San Francisco, CA, USA.
Michigan State University, College of Osteopathic Medicine, Department of Physiology, East Lansing, MI, USA.
J Cardiol. 2018 Jul;72(1):42-49. doi: 10.1016/j.jjcc.2018.02.003. Epub 2018 Mar 12.
High salt intake is one of the major dietary determinants of hypertension and cardiovascular disease in Japan and throughout the world. Although dietary salt restriction may be of clinical benefit in salt-sensitive individuals, many individuals may not wish, or be able to, reduce their intake of salt. Thus, identification of functional foods that can help protect against mechanistic abnormalities mediating salt-induced hypertension is an issue of considerable medical and scientific interest. According to the "vasodysfunction" theory of salt-induced hypertension, the hemodynamic abnormality initiating salt-induced increases in blood pressure usually involves subnormal vasodilation and abnormally increased vascular resistance in response to increased salt intake. Because disturbances in nitric oxide activity can contribute to subnormal vasodilator responses to increased salt intake that often mediate blood pressure salt sensitivity, increased intake of functional foods that support nitric oxide activity may help to reduce the risk for salt-induced hypertension. Mounting evidence indicates that increased consumption of traditional Japanese vegetables and other vegetables with high nitrate content such as table beets and kale can promote the formation of nitric oxide through an endothelial independent pathway that involves reduction of dietary nitrate to nitrite and nitric oxide. In addition, recent studies in animal models have demonstrated that modest increases in nitrate intake can protect against the initiation of salt-induced hypertension. These observations are: (1) consistent with the view that increased intake of many traditional Japanese vegetables and other nitrate rich vegetables, and of functional foods derived from such vegetables, may help maintain healthy blood pressure despite a high salt diet; (2) support government recommendations to increase vegetable intake in the Japanese population.
高盐摄入是日本乃至全球高血压和心血管疾病的主要饮食决定因素之一。尽管限制饮食中的盐分对盐敏感个体可能具有临床益处，但许多人可能不愿意或无法减少盐的摄入量。因此，确定有助于预防介导盐诱导高血压的机制异常的功能性食品是一个具有重大医学和科学意义的问题。根据盐诱导高血压的“血管功能障碍”理论，引发盐诱导血压升高的血流动力学异常通常涉及血管舒张功能减退以及对盐摄入量增加的异常血管阻力增加。由于一氧化氮活性紊乱会导致对盐摄入量增加的血管舒张反应减弱，而这种反应通常介导血压盐敏感性，因此增加支持一氧化氮活性的功能性食品的摄入量可能有助于降低盐诱导高血压的风险。越来越多的证据表明，增加传统日本蔬菜以及其他高硝酸盐含量蔬菜（如甜菜根和羽衣甘蓝）的摄入量，可以通过一种不依赖内皮的途径促进一氧化氮的形成——该途径包括将膳食硝酸盐还原为亚硝酸盐和一氧化氮。此外，最近在动物模型中的研究表明，适度增加硝酸盐摄入量可以预防盐诱导高血压的发生。这些观察结果表明：（1）与以下观点一致——尽管饮食中盐分含量高，但增加许多传统日本蔬菜和其他富含硝酸盐蔬菜以及由此类蔬菜制成的功能性食品的摄入量，可能有助于维持健康血压；（2）支持政府关于增加日本人群蔬菜摄入量的建议。
